阿奇霉素联合香砂六君子汤对糖尿病胃轻瘫患者血清胃动素和生长抑素水平的影响及疗效观察

Influence and curative effect of Azithromycin combined with Xiangsha Liujunzi decoction on serum motilin and somatostatin levels of patients with diabetic gastroparesis

[目的]探讨阿奇霉素联合香砂六君子汤对糖尿病胃轻瘫(DGP)患者血清胃动素(MTL)和生长抑素(SS)水平的影响及疗效观察。[方法]将78例DGP患者随机分为中西医组和西医组各39例。2组予控制饮食、适量运动和控制血糖等基础治疗。西医组加用口服阿奇霉素肠溶片0.25g/次,1次/d;中西医组在西医组基础上加用香砂六君子汤加减口服治疗,1剂/d,水煎取汁200ml,分2次口服,疗程8周。观察比较2组治疗前后血清MTL和SS水平变化,评估其疗效及不良反应。[结果]治疗8周后,2组血清MTL水平较前上升,血清SS水平较前下降(P<0.05或P<0.01),且中西医组上升或下降大于西医组(P<0.05);同时中西医组总有效率(94.87%)高于西医组(76.92%)(χ2=5.19,P<0.05)。中西医组和西医组分别出现不良反应5例和3例,症状均相对较轻,2组比较差异无统计学意义(χ2=0.14,P>0.05)。[结论]阿奇霉素联合香砂六君子汤治疗DGP疗效确切,安全性较好,作用机制可能与其能升高血清MTL水平,降低血清SS水平,调节胃肠激素紊乱密切相关。

[Objective]To discuss the influence and curative effect of Azithromycin combined with Xiangsha Liujunzi decoction on serum motilin（MTL）and somatostatin（SS）levels of patients with diabetic gastroparesis（DGP）.[Methods]Seventy-eight cases of patients with DGP were selected and divided into traditional Chinese and western medicine group and western medicine group at random,with 39 cases of patients in each group.The patients in two groups were given basic medical treatment,such as strict diet control,suitable exercise,control of blood sugar,etc.The patients in western medicine group were additionally given 0.25 g Azithromycinonce a day,while the patients in Chinese and western medicine group were additionally given adjusted Xiangsha Liujunzi decoction one dose per day（200ml decoction twice aday）The course of treatment was 8weeks.The changes of serum MTL and SS levels of patients before and after medical treatment were observed and compared,and the clinical curative effect and drug adverse reaction（DAR）were evaluated as well.[Results]After 8weeks＇ treatment,serum MTL levels in both groups obviously increased than before,while the serum SS levels obviously declined than before（P〈0.05 or P〈0.01）,and the rising or declining rates of patients in traditional Chinese and western medicine group were much higher than those in western medicine group（P〈0.05）.Meanwhile,total clinical efficiency of patients in traditional Chinese and western medicine group（94.87%）was much higher than that in western medicine group（76.92%）（χ^2=5.19,P〈0.05）.Five and three cases of DAR appeared in patients in traditional Chinese and western medicine group and western medicine group,with relatively mild symptoms.There was no significant difference in the DAR occurrence rates between the two groups（χ^2=0.14,P〉0.05）.[Conclusion]Azithromycin combined with Xiangsha Liujunzi decoction has reliable curative effect on patients with DGP,with high security,whose mechanism of action has close effect on raising serum MTL level,reducing serum SS level and adjusting disorder of gastrointestinal hormone disorder.